A 2-year-old child with minimal cyanosis has an S3 and S4 (a quadruple rhythm), systolic murmur in the pulmonic area, and a middiastolic murmur along the lower left sternal border. An electrocardiogram shows right atrial hypertrophy and a ventricular block pattern in the right chest leads. Which of the following is the most likely diagnosis?

a. Tricuspid regurgitation and pulmonic stenosis

b. Pulmonic stenosis and a ventricular septal defect (tetralogy of Fallot)

c. An atrioventricular canal

d. Ebstein anomaly

e. Wolff-Parkinson-White syndrome

the answer is below…

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